Organization Active NPI

Sa Dental LLC

  • Pediatric Dentistry
  • Omaha, NE
National Provider Identifier
1043178593
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
SA DENTAL LLC
Practice address
14450 Eagle Run Dr Ste 290
Omaha, NE 68116-1493
Phone
(402) 964-9009
NPI assigned
Jan 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda Lightfoot
Title
Authorized Official
Phone
(214) 702-0708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

14450 Eagle Run Dr Ste 290
Omaha, NE 68116-1493

Mailing address

15660 Dallas Pkwy Ste 950
Dallas, TX 75248-3309

National Provider Directory

National Provider Directory

Locations

14450 Eagle Run Dr
Ste 290
Omaha, NE 68116
Phone (402) 964-9009

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769558400000",
    "number": "1043178593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15660 DALLAS PKWY STE 950",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752483309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14450 EAGLE RUN DR STE 290",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681161493",
            "telephone_number": "402-964-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SA DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A",
        "authorized_official_last_name": "LIGHTFOOT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-702-0708"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.